Your Dental Visit:
What to Expect
Types of
Dental Visits
Most people are familiar with the typical
dental checkup visit. If the office has a
dental hygienist, he or she will clean your
teeth, do an examination and take X-rays.
Then the dentist will check the X-rays and
your teeth for signs of decay, check your
gums for changes, and check for signs of
cancer or other diseases.
Periodically, however, your dentist should
do a more thorough examination, usually
called a comprehensive examination. A
comprehensive dental examination not only
checks for tooth decay, but includes a
through examination of your entire mouth,
head and neck area.
A comprehensive examination likely will be
done the first time you visit a dental
office. Even if you have had regular care
under another dentist, your new dentist will
want to become familiar with your health so
that he or she can notice changes or
problems more easily during future visits.
Although some activities are standard for
typical checkups and comprehensive
examinations, dentists have their own style
and skills. If your dentist doesn't do
everything listed, that doesn't necessarily
mean he or she isn't doing a good job. If
you are concerned, ask why certain things
are left out or why others are included.
The order in which things are done may vary
as well. And not everything necessarily will
be done at every visit.
An important part of every visit is updating
your medical history. Your dentist will want
to know if you've had any health changes
since your last visit and if you've started,
stopped, reduced, increased or changed
medications.
Mention everything about your health, even
if you don't think it relates to your mouth.
Many diseases can have significant effects
on your mouth and teeth, and researchers
continue to discover ways in which oral
health is related to overall health. For
example, researchers who examined the
effects of diabetes on the mouth and teeth
found that people with diabetes are at a
higher risk of developing periodontal
disease. Research also suggests that
periodontal infection can have an effect on
your blood sugar levels and make your
diabetes harder to control. Other health
conditions may require your dentist to
change the type of anesthesia given.
Bring a list of all medications you are
taking, with dosages. Some medications cause
dry mouth, which can increase the risk of
cavities. Your dentist also will want to
check that any medication he or she
prescribes doesn't interact with medications
you already are taking.
What To Tell Your Dentist
Your dentist needs to know everything that
may help him or her diagnose problems or
treat you appropriately. Tell your dentist:
Your fears
— Many people have fears of the dentist that
go back to childhood. Pain control and
treatment techniques change constantly, so
the things you fear most may not exist any
longer. If you fear you have a particular
disease or condition, let your dentist know
so he or she can look for signs and either
set your mind to rest or make a definitive
diagnosis. Often, just talking about your
fears will take some of the edge off.
Your overall health
— Your dentist should know if you've been
diagnosed with any diseases or are taking
any new medications. Even diseases that seem
to be unrelated to the mouth may require a
different approach to dental treatments or
prevention.
Your dental health
— If you think you have a new cavity, if
your teeth have become sensitive or if you
feel lumps on the inside of your mouth, tell
your dentist before the examination starts.
Don't wait to see if the dentist catches it
or silently hope the dentist misses it. By
telling your dentist your symptoms, you may
help him or her make an early diagnosis.
The Comprehensive Examination
During a comprehensive examination, your
dentist will look at much more than just
your teeth. He or she will check other areas
inside and outside your mouth for signs of
disease or other problems. The comprehensive
exam likely will include these evaluations:
Head and neck
— Your dentist will check your head and
neck, your temporomandibular joint, your
salivary glands and lymph nodes in your neck
area.
He or she will look at your face, neck and
lips to make sure there are no unusual
swellings, lip dryness, bleeding or other
abnormalities that need to be checked
further.
Your temporomandibular joint, often called
the TMJ, is the joint that guides your lower
jaw when you open your mouth. To see if your
temporomandibular joint is working properly,
your dentist will ask you to open and close
your mouth and to move your lower jaw from
side to side. You will be asked if you have
had any pain or soreness in the joint. Your
dentist may touch the joint while you open
and close your mouth to feel for hitches or
catches in movement that may indicate
problems.
Your dentist will touch salivary glands and
lymph nodes in your neck area to feel for
swelling or tenderness that may indicate
infection or disease.
Soft tissue
— The soft tissues of the mouth include the
tongue, the inside of the lips and cheeks
and the floor and roof of the mouth. Your
dentist will look at these areas to check
for spots, lesions, cuts, swellings or
growths that may indicate problems with oral
health.
Periodontal
— A periodontal examination involves
checking the gums and supporting structures
of the teeth. First, your dentist will look
at the gums for signs of redness or
puffiness and may poke them gently to see
how easily they bleed. These symptoms may
indicate gum disease. Your dentist may use a
special probe to measure the depth of the
pockets between your teeth and your gums.
Pockets deeper than 3 millimeters often
indicate periodontal disease. If your
dentist determines that you have periodontal
disease, he or she may refer you to a
periodontist, a specialist who treats
diseases of the gums.
Occlusion
— Your dentist may check how well your teeth
fit together by examining your bite. First,
you will be asked to bite naturally. If the
teeth don't seem to fit together properly,
your dentist may do further checks by having
you bite down on special wax or paper. Your
teeth make an impression in the wax that can
help show how your teeth meet. The paper
makes temporary marks on your teeth that
show where your teeth come together.
Clinical
examination of teeth — Your
dentist will check for decay by examining
every tooth surface visually (using a mirror
to see the back sides of teeth). He or she
also will poke your teeth with a tool called
an explorer to detect cavities. Decayed
enamel is softer than healthy enamel. If you
have fillings, permanent bridges, crowns or
other restorations, your dentist will check
to make certain that they remain whole and
sound and that the teeth around them have no
sign of decay.
X-rays —
X-rays, also called radiographs, will be
taken to help your dentist look for decay or
other oral health problems
Checkups
During a checkup visit, you sometimes will
see two professionals — your dentist and the
dental hygienist if the office has a
hygienist on staff. The hygienist will
typically check your gums and teeth, clean
and polish your teeth and talk to you about
caring for your teeth and gums properly at
home.
Your dentist also may do a clinical
examination, diagnose problems and make
treatment recommendations. Here's what to
expect:
Cleaning
— The purpose of a professional dental
cleaning is to remove the hard calculus
(also called tartar) from above and just
below the gum line. Brushing and flossing at
home removes plaque, but only dental
instruments can remove calculus. Some dental
hygienists use ultrasonic instruments to
blast away the larger chunks of tartar and
follow up with hand instruments to
thoroughly clean the teeth. Other hygienists
use only hand instruments.
Polishing
— After the calculus is removed, the crowns
of your teeth (the parts that show) may be
polished to remove plaque and surface
stains. Typically, but not always, an
abrasive substance is applied to the teeth
with a small rotating rubber cup or brush to
scrub away the stains. The polishing
substance will feel gritty in your mouth.
You will be given a chance to rinse
periodically.
Prevention — The hygienist may offer additional
instructions for oral care at home based on
the results of the exam. He or she may
demonstrate how to brush and floss properly.
Sometimes, the hygienist will instruct you
to use a disclosing agent to test your
brushing ability. A disclosing agent is a
red solution or tablet that, when applied to
the teeth or chewed, attaches to plaque and
colors it to make it visible. Then you brush
your teeth. Any remaining plaque will be
clearly visible, highlighting the areas the
brush missed. Not all dentists and
hygienists recommend disclosing agents
because they can be tricky to use. That's
because the disclosing agents will highlight
areas of plaque that can be removed only by
professional polishing, and they can stain
tooth-colored fillings. Some experts
recommend using a disclosing agent only at
the dentist's office and only if the
hygienist is prepared to polish any
remaining red color off the teeth afterward.
X-rays —
X-rays, also called radiographs, may or may
not be taken during your checkup. In the
past, many dentists took X-rays at every
checkup. But current recommendations by the
U.S. Food and Drug Administration (FDA)
state that X-rays do not always need to be
taken at every visit. Although dental X-rays
are safe, the FDA says unnecessary exposure
should be limited because the effects of
radiation are cumulative, and people are
exposed to radiation from numerous other
sources as well. Some people may be able to
go as long as two years between X-rays,
whereas others may need them every few
months. You dentist should take into
consideration the results of your clinical
examination, your dental history and your
individual risk for developing cavities. If
you are seeing a dentist for the first time,
ask for a copy of your X-rays from your
former dentist to avoid repeating X-rays
unnecessarily.
Treatment
recommendations — If your dentist
finds any problems during the examination,
he or she will make recommendations for the
next steps to fix them. These may include a
referral to a specialist (such as a periodontist or orthodontist), further tests
for diagnosis, or a suggestion that you
return for restoration work or more
intensive periodontal cleanings.
The Gag Reflex
The gag reflex, located on the back wall of
the throat, helps keep objects from going
down your windpipe. If you have ever put
your fingers too far back in your mouth and
felt like gagging or throwing up, you've
discovered the gag reflex. Some people have
a very sensitive gag reflex, which makes
going to the dentist very difficult.
If you are one of these people, talk with
your dentist about your concerns. Sometimes,
a new dentist or hygienist may place
instruments in a sensitive spot, touching
the soft palate (the entrance to your
throat). By warning the dentist or hygienist
ahead of time, they should be able to avoid
certain sensitive areas. Also, there may be
things you are doing to aggravate the
problem. For example, some patients draw
their tongue back to give the dentist room
to work, but they end up gagging themselves.
You and your dentist or hygienist can work
together to find ways to avoid gagging
movements.
Distraction may also work. Patients who are
highly concerned about gagging become tense
in the chair, and tension can heighten the
sensitivity. Bring a portable music device
and listen to music, practice meditation or
focus on trying to keep your feet elevated
one inch off the chair. These kinds of
distractions can help you keep your mind off
your throat.
[
back to top
] |